Low back pain is a common complaint that affects the population at some point in their lives. This symptom can arise from numerous sources within the lower back, hips, and pelvis. While disc herniations, muscle strains, and degenerative changes may be implicated, sacroiliac (SI) joint pain is a common but often overlooked cause of this discomfort. Understanding this condition is advisable for accurate diagnosis and optimal management.
Understanding the Sacroiliac (SI) Joints
The sacroiliac (SI) joints are located on either side of the lower spine, connecting the sacrum (the triangular bone at the base of the spine, just above the tailbone) to the ilium (the largest bone of the pelvis). Essentially, they form a bridge between the spine and pelvis.
While the SI joints have limited movement compared to the knee or shoulder, their role is incredibly important. They act as shock absorbers, transferring weight and forces between the upper body and the legs. This subtle movement, along with the ligaments surrounding it, contributes to the stability and mobility of the entire pelvic girdle and spine. Dysfunction in these joints can potentially disrupt this balance.
Symptoms of SI Joint Pain
The symptoms associated with SI joint pain can vary; however, individuals may experience discomfort in the lower back, buttocks, and occasionally the hip. This radiating pain can even extend down the leg. Patients may describe it as a dull ache, though it can also be sharp, stabbing, or burning.
Aggravating factors commonly include:
- Prolonged sitting or standing
- Climbing stairs
- Running
- Simply shifting weight
- Activities that involve twisting or rotating the spine
It is advisable to distinguish sciatica from SI joint pain. While the sensations might feel similar, the origin may differ, requiring a distinct diagnostic approach. When considering various causes of hip pain, the sacroiliac (SI) joint should always be considered due to its proximity and functional role.
Diagnosing Sacroiliac Joint Dysfunction at The Pain Clinic
Diagnosing sacroiliac joint dysfunction often requires a comprehensive approach, as its symptoms can overlap with other low back conditions. The diagnostic process during your first pain management appointment may involve:
- Detailed physical examination: Specific provocative tests may be performed to stress the SI joint and elicit pain. This may help identify where SI joint pain is felt most intensely and what it feels like during these movements.
- Thorough patient history: A detailed account of the pain's onset, characteristics, and aggravating factors may be necessary.
- Diagnostic spinal injections: In many cases, a definitive diagnosis may be achieved through diagnostic spinal injections. A small amount of anaesthetic is injected directly into the SI joint. If this injection helps relieve the pain, it may suggest that the sacroiliac joint could be the source of the discomfort.
It is also worth noting that sometimes patients undergo major spinal fusion surgery without getting better, only to find out that their pain may be coming from the SI joint. This highlights the importance of an accurate diagnosis at an early stage.
Treatment Options for SI Joint Pain in Singapore
Once sacroiliac (SI) joint dysfunction is diagnosed, various treatment options may be recommended to help with pain relief and improve function. Conservative measures are often the first line of approach. These can include:
- Physical therapy: Focusing on exercises to strengthen core muscles, improve flexibility, and correct postural imbalances.
- Manual therapy techniques: Performed by a qualified medical professional, these may help improve normal joint mechanics.
When conservative methods are deemed insufficient, injection therapy may play a role in SI joint pain management.
- Sacroiliac joint injections: Often involving corticosteroids and local anaesthetics, these may help address inflammation and pain directly at the source.
- Nerve pain relief injections: For optimal relief, procedures such as a radiofrequency ablation may target the nerves supplying the SI joint.
In rare and severe cases where other treatments have failed, surgical intervention may be considered.
Why Early and Accurate Diagnosis of SI Joint Pain Matters
An early and accurate diagnosis of sacroiliac joint pain can minimise unnecessary or ineffective treatments. If the primary issue is SI joint dysfunction, focusing solely on lumbar disc problems may not provide the desired relief.
Targeted treatment for sacroiliac joint pain can potentially lead to pain relief and improved function, allowing individuals to resume their daily activities and improve their quality of life. Understanding pelvic pain symptoms and recognising when they might point to an SI joint issue is also vital.
If you're experiencing persistent low back pain, hip flexor pain, or radiating pain that you suspect might be related to your SI joint, it is advisable to seek a pain management clinic in Singapore. Contact The Pain Clinic today to book a consultation and explore your treatment options.